Game of thrones: immunotherapy versus molecular targeted therapy in renal cell cancer scenarios

Objectives Treatment for advanced renal cell carcinoma (RCC) has become increasingly more complex over the last several years. Objective 1 is to which treatment option is immunotherapy, targeted therapy, or the combination of immunotherapy with targeted therapy the best for patients? Objective 2 is to study which regimens with the highest chance of cure/durable response and what is the optimal sequence in advanced RCC. Materials and methods Between 2016 and 2018, 6 adult patients admitted to our institute with RCC were reviewed. Clinical information, treatment and outcomes were retrieved for further analysis. This applies to all risk groups as determined by the International Metastatic RCC Database Consortium criteria. We have intended to provide the reader with a comprehensive and authoritative review of the broad subject of RCC. Results Immunotherapy-based regimens and the functioning of various growth-and survival-promoting kinases, specifically, receptor-associated tyrosine kinases have dramatically changed the treatment landscape of advanced RCC. Recent phase III trials have demonstrated a survival benefit for front-line ipilimumab plus nivolumab therapy, and immune checkpoint inhibition plus anti-vascular endothelial growth factor combination therapy in metastatic clear-cell RCC. Conclusion In renal cell carcinoma, rapid and successful drug development has resulted in multiple treatment options, requiring careful decision making for individual patients and have emphasized how newly developed therapies work.